Jamie Francis/The OregonianOregon is building a new state hospital in Salem that will have 22 courtyards, none of them surrounded by razor or barbed wire. Jamie Francis/The Oregonian

SALEM -- Well aware that it costs taxpayers more than $200,000 a year to keep a patient at the state mental hospital, Oregon lawmakers are considering two proposals aimed at cutting costs.

The first would make it more difficult to use the insanity defense to get into the Oregon State Hospital. The second would make it easier for people to get out.

These proposals might have sparked heated controversy in any other year from those worried about public safety or patients' care. But Oregon faces a $3.5 billion budget hole and legislators say they're willing to consider changes to the Psychiatric Security Review Board, which was the first of its kind in the nation when it was created in 1978.

"We're working to see what we can do to make the current system more efficient," said Sen. Floyd Prozanski, D-Eugene.

As of Monday, 417 of the 582 patients in state mental wards were there because they plead "guilty except for insanity" of a crime.

Earlier this year The Oregonian found there are no statewide standards for evaluating which criminal defendants should be allowed to make the insanity plea. The newspaper also reported that nearly 100 of the patients who were in the Oregon State Hospital had committed low-level felonies and misdemeanors for which they might have gotten probation. And many patients who had been deemed ready for release had been waiting for months or even years to move.

Lawmakers say House Bill 3100, which awaits action in a budget committee, would address the hospital's "front door problems." It would require an evaluation by a state-certified psychologist or psychiatrist before a person could successfully plead guilty except for insanity.

The bill also specifies that people who commit misdemeanor crimes would be sent to the state hospital and its intensive care setting only if they presented a substantial danger to others.

A fiscal analysis estimates such changes could save $300,000 in the next two-year budget.

On Monday, the Senate Judiciary Committee held its first hearing on a plan that sponsors say addresses the "back door."

Senate Bill 420 proposes to give the Oregon Health Authority rather than the Psychiatric Security board the final decision on when a patient is ready for release.

State law currently dictates the board's primary responsibility is protecting public safety. As a result, board members have been taken a conservative approach to releasing patients who have committed crimes in the past.

The Senate bill, negotiated by a team included the chief justice of the Supreme Court, would let the Health Authority determine when a patient no longer needs intensive hospital treatment. The Psychiatric Security Board would continue to monitor the person after release.

Patients and advocates for those with mental illnesses supported the change at Monday's hearing. "It balances the treatment needs of the individual with public safety," said Matthew Kirby, who has been a patient at the state hospital for more than a year.

Savings are still being calculated. The committee vote should occur this week.